AccountId: 011433970860
ContactId: ebd19041-2605-4f16-861a-490c5a1f5bd8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 524058 ms
Total Talk Time (AGENT): 219898 ms
Total Talk Time (CUSTOMER): 170766 ms
Interruptions: 0
Overall Sentiment: AGENT=2.6, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/ebd19041-2605-4f16-861a-490c5a1f5bd8_20250109T17:00_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name's [PII]. I'm calling because I received an explanation of benefits that was rejected, I guess, by my insurance, saying it wasn't covered because I didn't have coverage on the date, but I have a letter from the company saying my coverage was effective on that date, so I wanted to know how to resolve it.
[AGENT][POSITIVE] OK, yeah, absolutely, um.
[CUSTOMER][NEGATIVE] I did go online, but it won't let me create a profile for some reason. It says I'm not eligible to have a profile.
[AGENT][NEUTRAL] OK, yeah, let's take a look at all that. Um, so we're gonna look at the claim and we're gonna look at the online service center for you. What is your policy number, sir?
[CUSTOMER][NEUTRAL] The policy number is 025194778.
[AGENT][POSITIVE] Perfect and.
[AGENT][POSITIVE] Awesome, can I get your first and last name please and a good callback number?
[CUSTOMER][NEUTRAL] Uh, [PII], [PII].
[AGENT][POSITIVE] Thank you, I appreciate that. And [PII], can you verify for me please your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. And can you verify for me pretty please your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, I appreciate that and then the last thing is if you could just verify for me please your email address on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, it looks like it could be your professional email.
[CUSTOMER][NEUTRAL] [PII] maybe.
[AGENT][NEUTRAL] Uh, the domain name is different. It like it maybe with the pharmacy.
[CUSTOMER][NEUTRAL] CPS or contract pharmacy services it could have been.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yep, that's it and then do you want me to update that email for me for you?
[CUSTOMER][NEUTRAL] Uh, I mean, I don't work there anymore so it doesn't matter what you do with it.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, no worries. um, all right, so let me take a look at this information real quick for you, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, so I very first thing, um, I am looking at that claim with you. It looks like it's saying that the.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Services were rendered after the coverage was terminated on your policy. It looks like on this the date of service.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Right, with [PII].
[AGENT][NEUTRAL] 6. And uh I have your policy term date as [PII].
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Um, and it looks like I have a note put in here, um, that
[AGENT][NEUTRAL] There was a bookkeeper request to terminate the policy for [PII].
[CUSTOMER][NEUTRAL] That's funny because I still worked there until [PII].
[CUSTOMER][NEUTRAL] Um, so yeah, I worked at Polaris Pharmacy until [PII], not [PII], so I'm not sure how they canceled it retro and I even have.
[CUSTOMER][NEUTRAL] The COR coverage letter in front of me that they need to offer you, and it says you're getting this notice because your coverage under the plan will end on [PII].
[CUSTOMER][NEUTRAL] So I was covered until the last day of October, which was also what I was verbally told while I was there.
[AGENT][NEUTRAL] All right, let me check this.
[CUSTOMER][NEUTRAL] So I mean, I was going to, when I was trying to get online, I was going to
[CUSTOMER][NEUTRAL] Copy the page of the Cobra letter and then you know put that in so that you guys would be able to see it but um.
[CUSTOMER][NEUTRAL] Uh like I said, it wouldn't let me start.
[CUSTOMER][NEUTRAL] An account or a claim.
[AGENT][NEUTRAL] All right, so.
[AGENT][NEUTRAL] What I can do is, do you mind if I put in a request um for.
[AGENT][NEUTRAL] Do you mind if I put in a request for to escalate this and have somebody reach back out to you? I'm not sure.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Exactly how that works, but I definitely wanna make sure you have somebody who can give you the answers you need.
[CUSTOMER][POSITIVE] Sure, not a problem.
[AGENT][POSITIVE] OK, perfect. I am going to.
[AGENT][NEUTRAL] Start
[AGENT][NEUTRAL] The request and I just wanna make sure I'm covering all my basis or not on my basis, but like I'm getting everything we have in here and so I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] I'm going to include that you have a letter stating your coverage was active until [PII] from from a letter like offering COR, um, that you are wanting to know.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] How the policy was canceled retroactively.
[CUSTOMER][NEUTRAL] Right, because I was employed until the [PII].
[AGENT][NEUTRAL] [PII] and then is there any other information you're wanting me to include in in this as far as questions that you have or concerns you have that you need answers for?
[CUSTOMER][NEUTRAL] Well I mean this bill is for 100 and uh what is it?
[CUSTOMER][NEGATIVE] Like $148 which I'm, I mean I'm not paying because I wasn't responsible to pay that on that day.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So like I said, I have the COR letter showing that
[CUSTOMER][NEUTRAL] my coverage was supposed to be till [PII] inclusive, and I also have the pay stub showing that I was employed in October.
[CUSTOMER][NEGATIVE] So I don't know again how they went back and can't I mean this company does more shady stuff I can't even tell you, but I don't know how they went back and canceled me before I was even let go, you know what I'm saying, and on top of that all that it was a wrongful termination. I mean the insult upon injury is ridiculous.
[AGENT][POSITIVE] OK, I will, I definitely understand like why you want some answers and I would be frustrated in your situation too so let me go ahead let me send this up to somebody who um will be able to get either they can give me the answers and I will happily call you back or I will have somebody give you a call back um to talk you through what went on what happened or if there's options from here um and I wish I had that information with me right now I'm sorry I don't.
[AGENT][NEUTRAL] Um, the number you gave me, is that a good contact number?
[CUSTOMER][NEUTRAL] Yeah it is.
[AGENT][POSITIVE] Perfect and are we welcome to leave voicemails on that phone number?
[CUSTOMER][NEUTRAL] Certainly sure.
[AGENT][POSITIVE] Perfect alrighty I'm going to go ahead and get that working for you. Um, other than that, is there anything else I can help you with, my friend?
[CUSTOMER][NEUTRAL] Uh, no, that would be it.
[AGENT][POSITIVE] All right, perfect. Thank you so much, [PII] for your patience and if there's anything else you need, I mean, always feel free to give us a call.
[CUSTOMER][POSITIVE] No, thank you, [PII]. I appreciate your help.
[AGENT][POSITIVE] Yeah, my pleasure. Thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.